Top hospitals likely are available on a marketplace plan, study

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hospital-ratings-570By Michelle Andrews
KHN

Despite much hand-wringing over the size and quality of provider networks on the health insurance marketplaces, many top-notch hospitals are available in-network in marketplace plans this year, a new study found.

However, more than half of those hospitals participated in fewer plans than last year, limiting their in-network availability to just one marketplace plan in a growing number of cases.

The analysis by the Robert Wood Johnson Foundation examined the marketplace plan participation in 2015 and 2016 of 156 hospitals that were highly ranked on U.S. News and World Report’s most recent list of Best Regional Hospitals based on clinical care and other measures.

More than 95 percent of highly rated regional hospitals were available in at least one marketplace plan.

Overall, the study found that more than 95 percent of highly rated regional hospitals were available in at least one marketplace plan in both years.

Following reports of marketplace plans with narrow provider networks and declines in the number of preferred provider organization plans with out-of-network coverage, “some people were starting to say that marketplace coverage is second-tier coverage,” said Katherine Hempstead, who leads the foundation’s work on health insurance coverage and authored the study.

The analysis showed that marketplace plans are “not so dissimilar from employer-sponsored insurance,” she said. “The cost-sharing might be more aggressive [in marketplace plans], but they’re not that dissimilar.” Continue reading

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Lumber Liquidators’ flooring has low cancer risk, CDC says – Chicago Tribune

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3-D model of formaldehyde: CH2O

3-D model of formaldehyde: CH2O

Lumber Liquidators Holdings flooring, tested by U.S. regulators after an outcry over formaldehyde, was found to have a low risk of causing cancer, though it could potentially trigger irritation and breathing problems.

“Breathing in very high levels of formaldehyde over many years has been linked to rare nose and throat cancers in workers,” the CDC said in the report.

“Formaldehyde exposure from the tested laminate flooring would be much lower and would last for less time than the exposures linked to cancer. We estimated the risk of cancer from exposure to this flooring and it’s low.”

Source: Lumber Liquidators’ flooring has low cancer risk, CDC says – Chicago Tribune

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Education May Cut Dementia Risk, Study Finds – The New York Times

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Photo by Darren Hester

The risk of developing dementia is decreasing for people with at least a high school education, according to an important new study that suggests that changes in lifestyle and improvements in physical health can help prevent or delay cognitive decline.

The study, published Wednesday in The New England Journal of Medicine, provides the strongest evidence to date that a more educated population and better cardiovascular health are contributing to a decline in new dementia cases over time, or at least helping more people stave off dementia for longer.

Photo by Darren Hester

Source: Education May Cut Dementia Risk, Study Finds – The New York Times

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Zika pushes 38 percent of U.S. businesses surveyed to let workers defer trips | Reuters

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AirplaneSome 38 percent of U.S. multinationals, universities and non-profits surveyed by an arm of the State Department are allowing female employees to defer travel or leave countries where the Zika virus has been reported.

A fifth of the 321 respondents said they were giving male employees similar options, a sign of how employers’ travel policies are diverging as they react to the mosquito-borne virus and uncertainty about the way it is transmitted.

Source: Zika pushes 38 percent of U.S. businesses surveyed to let workers defer trips | Reuters

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Elderly patients rarely included in decision to use intensive care | Reuters

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Close Up on an intensive care unit's heart monitor.

According to a study of 15 emergency departments, patients over age 80 who are admitted to intensive care are often not asked their opinion about admission.

“The relationship between physicians and their patients has changed over the last decades and patients’ empowerment has led to a greater self autonomy in medical decisions,” but apparently not when it comes to moving elderly patients into an intensive care unit, said lead author Dr. Julien Le Guen of Universite Paris Descartes in France.

Source: Elderly patients rarely included in decision to use intensive care | Reuters

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Not sure if we can help you with an insurance problem? Ask us anyway

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MKreidlerPhotoBy Mike Kreidler
Washington State Insurance Commissioner

Recently, a Washington consumer posted a story on Facebook about her brother, who was on the waiting list for a heart transplant but was being put on hold because of “paperwork” issues with the insurance company. She asked her Facebook friends to file a complaint with the Insurance Commissioner, resulting in more than 40 complaints to our office.

One of our consumer advocates looked into the complaint and determined that the insurance provider was Apple Health, our state’s Medicaid program that is overseen by the Washington state Health Care Authority. In other words, we have no authority over the plan. But that didn’t deter our consumer advocate from trying to help. Continue reading

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Waiting lists grow for medicine to fight opioid addiction

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A self-serve supply of needles and containers for their disposal at a Burlington, Vermont, needle exchange center that distributes more than 2,500 needles every day. As the opioid epidemic mushrooms, the demand for treatment is outpacing capacity.

By Christine Vestal
Stateline

BURLINGTON, Vermont — After more than a decade of getting high on illicit opioid painkillers and heroin every day, Christopher Dezotelle decided to quit. He saw too many people overdose and die. “I couldn’t do that to my mom or my children,” he said.

He also got tired of having to commit crimes to pay for his habit — or at least the consequences of those crimes. At 33, he has spent more than 11 of his last 17 years incarcerated. The oldest of seven children, he started using marijuana and alcohol when he was 12.

It’s been five years since Dezotelle started treatment the first time, and he still hustles for drugs every day. Only now, instead of heroin or OxyContin, he’s trying to score buprenorphine, one of three federally approved opioid-addiction medications. He says heroin is much easier to find, and it’s less than half the price of buprenorphine on the streets and parking lots of this college town.

Vermont Gov. Peter Shumlin, a Democrat, was among the first in the nation to address the opioid epidemic. He devoted his entire State of the State address to the crisis in 2014. Since then, his administration and many of Vermont’s private practice doctors have made treatment more available than it is in most of the country.

But it’s not enough.

In this state of about 626,000, almost 500 addicts are on waiting lists to receive medication for opioid dependence. More than half will wait close to a year.

sln_Prescribers

Nationwide, a shortage of doctors willing to prescribe buprenorphine, which reduces drug cravings, and a federal limit on the number of patients they can treat, prevents many who could benefit from the addiction medication from getting it.

Less than half of the 2.2 million people who need treatment for opioid addiction are receiving it, U.S. Health and Human Services Secretary Sylvia Burwell said this month, previewing President Barack Obama’s new budget, which was released Tuesday and proposes $1.1 billion to expand the availability of buprenorphine and other opioid-addiction medications.

Where are the Doctors?

Continue reading

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Farm contractors balk at Obamacare requirements

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USDA photo by Lance Cheung.

USDA photo by Lance Cheung.

By April Dembosky, KQED
KHN

Obamacare is putting the agricultural industry in a tizzy.

Many contractors who provide farm labor and must now offer workers health insurance are complaining loudly about the cost in their already low-margin business.

Some are also concerned that the forms they must file with the federal government under the Affordable Care Act will bring immigration problems to the fore. About half of the farm labor workforce in the U.S. is undocumented.

“There’s definitely going to be some repercussions to it,” said Jesse Sandoval, a farm labor contractor based in Stockton, California. “I think there’s going to be some things that cannot be ignored.”

“Under the Affordable Care Act, employees can be asked to contribute 9.5 percent of their income toward health premiums. But for farm workers who pick oranges or peaches for $10 an hour, that’s still too much.”

Sandoval came to an educational conference for farm labor contractors — essentially staffing agencies for field workers — held at the San Joaquin County Agricultural Center in Stockton in the fall.

Men with broad shoulders, wearing denim jackets and cowboy hats, sat in the audience, listening to lectures on a litany of laws and rules regulating their industry, including Obamacare’s employer mandate.

Last year, employers with 100 or more full-time employees had to offer health insurance to their workers or pay a stiff penalty. This year, employers with 50 to 99 full-time employees must comply.

Sandoval has about 100 workers on his payroll. When farmers need a crew to pick cherries, pumpkins or asparagus, they call him to send the workers. He has to offer them insurance this year, and he’s smarting over the price tag. At $300 a month per employee, he’s looking at a $30,000 monthly bill.

Sandoval said he can’t absorb the hit. “The numbers aren’t there,” he said. “My margin is 10 percent, and I have to increase expenses 10 percent? Well, that doesn’t work.” Continue reading

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There’s a horse in my coffee shop – Is that okay?

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12/14/2002 -- Ellsworth, Maine -- Dan Shaw and his Guide Horse Cuddles make their way through a shopping mall.

12/14/2002 — Ellsworth, Maine — Dan Shaw and his Guide Horse Cuddles make their way through a shopping mall.

Image via Reddit.

Lindsay Bosslet
Public Health – Seattle & King County

“I saw a cat at my coffee shop.” 

“There’s a small horse in the grocery store.”

“Do I have to let dogs into my bakery?”

These are the types of questions and complaints we receive from concerned members of the public and business owners about animals inside restaurants and other places where food is bought and served.

So, we’re here to set the record straight. Here’s everything you need to know. Continue reading

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Will Healthcare.gov get a California makeover?

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California exchangeBy Pauline Bartolone
KHN

When 28-year-old Charis Hill discovered that the medication to treat her degenerative arthritis condition had risen to $2,000 a month, she chose to be in pain instead.

“I felt like an invalid,” said Hill, who lives in Sacramento and at the time had only catastrophic health coverage. She said the month without medication made it hard to get out of bed.

Paying for drugs isn’t a problem for Hill now: She has a more robust Covered California health plan, and she gets assistance from a drug company program.

And as of the first of this year, she won’t have to worry about sticker shock if she switches medications. All Covered California plans have a cap on how much patients pay for drugs: $250 a month in silver, gold and platinum plans, and $500 a month in bronze plans.

“I could try a better treatment,” said Hill, a patient advocate, who says she is exploring that because her symptoms are becoming more severe. “The $250 is something I know that I can always fall back on.”

The copay cap on drugs is just one way Covered California chose to shape the health insurance marketplace this year.

Experts say the California exchange uses more of its powers as an “active purchaser” than the vast majority of other states.

That means it can decide which insurers can join the exchange, what plans and benefits are available and at what price.

The federal government — in pending proposed rules for 2017 — has signaled it too wants to have more of a hand in crafting plans. Though there are no plans to go as far as a monthly drug copay cap, healthcare.gov would be forging ahead on a path California already paved, swapping variety for simplicity in plan design. Continue reading

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Ninety One Thousand Apple Health Medicaid Clients Affected by Data Breach | Northwest Public Radio

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State Health Care officials say they’ll be notifying 91,000 Medicaid clients they’ve been affected by a data breach.

Officials with the Washington State Health Care Authority today said they discovered that the private information of 91,000 Apple Health clients was mishandled by two employees.

The information includes clients’ Social Security numbers, dates of birth, Apple Health client ID numbers and private health information.

The agency says the breach was discovered during a whistle blower investigation into misuse of state resources.

Source: Ninety One Thousand Apple Health Medicaid Clients Affected by Data Breach | Northwest Public Radio

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Veterans’ hospital performance similar to other U.S. hospitals | Reuters

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veteran-affairs-seal-vaFor older men with heart attack, heart failure or pneumonia, being treated at a Veteran’s Affairs (VA) hospital carries similar risks of death or hospital readmission compared to other facilities, according to a new study.

Rates of death from any cause within 30 days of admission were slightly lower at VA hospitals, and hospital readmission rates were slightly higher, but the differences were very small, researchers found.

Source: Veterans’ hospital performance similar to other U.S. hospitals | Reuters

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